HomeMy WebLinkAbout2717 YORK RD; ; 82-264; Permiten z 0 ;:: C a: C _,
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O I heret, .ttlrm that I am licensed under
provisions of .;hapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Professions Code, and my license Is In
full force and effect.
lie No ___ __ Class
I hereby aftlrm that I ¥TI exempt from the Con·
~!0l~~!~:e':: ~; ~f~~1~':-c2~~i~r
coonty which requires a permit to construct
alter, improve, demohsh. or repa,r any structure,
pnor to its issuance also requires the applicant tor such permit to file a signed statement that he 1s
hcensed pursuant to the pr°"1s1ons of the Con·
tractor's License Law (Chapter 9 commencing with
Section 7CXX) of 01v1s100 3 of ttle Business and Pro-
tesstOns Code) or that 1s exempt therefrom and the
basis tor the alleged exempttOn Any v,olat,on of Section 7031.5 by an applicant for a permit subjects
tne applicant to a c1v1I penalty of not more than five
hu:JPred dollars ($500)
I, as owner of the property, or my employees \.••th wages as their sole compensation, w,11 do the
'<,_ork, and the structure 1s not mlended Of offered for
sale (Sec. 7044, Busmess and Professiohs Code The Contractor's License Law does not apply to an
owner of property who builds or improves thereon a.nd who does such work-himself or lhrough his own
employees, provided that such ,mproveme:its ate
not 1ntende1 or offered lor sale. 11, however. the building Of improvement 1s sold w1th1n one yea, of
completion, the owner-OU1lder will have the burden
of proving that heAdij'._~ or improve lor the
purpose of sale) ~..,......-
□ I, as owner of the proper1y, am exclusively
contracting with licensed contractors to construct the pro1ect {Sec. 70.U, Business and Professions
Code· The Contracto(s license Law dOes not apply
to an owner of property who builds or improves
thereon. and who contracts lor each proJects with a
contractor(s) hcense pursuant to the Controetor's License Law)
0 I am exempt under sec
tor lt11s reason
.B & PC
D I hereby affirm ttiat I have a certificate of consen1
to self,msure. or a cert1f,cate of Workers·
Compensation Insurance. or a cert1f1ed cooy thereof
(Sec. 3800. ut>or Code!
POLICYN0 __
COMPANY
O Cooy 1s hied w1tt1 the city
0 Certified copy ,s hereby furnished
CERTIFICATl OF EXEMPTION FROM WORKERS" COMPENSATION INSURANCE (This section need nol be completed ti lhe permit
,s tor one hundred dollars {S H)O) or less)
D I certify that m the performance of the work for
which lh1s permit ,s issued. I shall nol employ any
person m any manner so as to become-sub1ec1 to the Workers· Compensation Laws of ca11torn1a
NOTICE TO APPLICANT 11. after mak1nJ lfus Cert,
hcate of Exemption, you should become subJecl I') the Wor11.ers· Compensation provisions of the labOr
Code. you must tor1hw1th comply w1tt1 such
provisions or this permit shall be deemed revoked
0 I hefeby affirm thal there 1s a cons1ruc11on lending agency tor ltle performance ol the wonl. tor
which lh1s oerm11 15 1ssued (Sec 3CIJ7. C1v1I COOe)
Lende-ls Name ___________ _
Lender's Address __________ _
---------' AP~L~CATION & PERMIT ~~ ~~~~~~!E. ~1~}r~~9~G (7~>~!.!:™ ENT "\
JOB ADDRESS
A~·i_T.l 7fr£7i~ BUSINESS LICENSE # VALUATION PERMIT NUMBER
21(7 YOf<K RoAD ~3-i--&92---Yt lf-OWNER'S NAIi/iE I +*:+i:69 PRIii/iE CONTRACTOR I CONTRACTORS PHONE # ZONE
R\cttMD 1-kALJ.BV J £' Ou/_,,,,£12. ,
OWNER'S I\IIAILING ADDRESS CONTRACTOR"S ADDRESS LICENSE NO. PLAN 1.0. # BLOG use CODE
~7(7 Yo(t!j(__ (loM> ' CA-~~ ( QI.-cn_oo, B"
S-J I BLOCK ls~~("t/t-I A1,,R =~~~-+ ..3 DESIGNER STATE LICENSE# STANDARD PLAN# BUILDING SO. FOOTAGE
DESCRIPTION OF woy ,) j -DESIGNER'S ADDRESS DESIGNER'S PHONE
~Ql2_ ;J. 1JA-TTD C ,.. ~ ~ £,.(l___ ---F/P FLA ELEV. NO OCC GP EDU 7 lei /6i=Si859 q(n ,P, •. }),~ v (Mo~\ STORIES 39;50
vO NO ocrrr,r~e~ ··11e2 1 8;:, 3a;,50 CENSUS TRACT I GP LANO USE PARKING Sl"ACE I RES UNITS I GRADING f'.ERMIT ISSUED I REOEVELOPI\IIENT TYPE OCC LOAD FIRE SPA
AREA CONST
y O N 0 v O NO v O NO Not Valid Unlt!ss Machine Certified
QTY. PLUMBING PERMIT -ISSUE 7.50 QTY. MECHANICAL PERMIT -ISSUE 3 .00 SUMMARY/ACCOUNT NUMBER --~
EACH FIXTURE TRAP INSTALL FURN. DUCTS iJP TO 100.000 BTU BUILDING PERMIT 01-000·4220 '.J )f • ..1,
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT/") 01.noo-4221 -
EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK1-!' ~ I-(') t 01 ·000·4806 -EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01 ·000·4222
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL 01-000-4223 -. .
EACH INSTAl.. ALTER. REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01 ·000·4224
EACH VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS M0BILEH0ME 01 ·000-4225
WATER S0FTNER RELOCATION Of EA FURNACE/HEATER MDBILEH0ME PARK INSP
EACH ROOF DRAIN (INSIDE) SOLAR 01 ·000·4226
T0T.t.l MECHANICAL STRONG MOTION 65·640·0519 ,-~ ...:...._
TOTAL PLUMBING FIRE SPRINKLERS 01 ·000·4227
PUBLIC FACILITIES FEE 25-000·4933 QTY. ELECTRICAL PERMIT -ISSUE 2 .00 QTY. SOLAR · ISSUE BRIDGE FEE
NEW CONST EA AMP/SWT /BKR COLLECTORS SCHOOL FEE · DISTRICT ,.
1 PH 3 PH STORAGE TAN KS Carlsbad 65·623·0519
EXIST BLDG EA AMP/SWT/BKR ROCK STORAGE Encinitas 65·624·0519
1 PH 3 PH PUMP San Oieguito 65·625-0519
REMODEL/ALTER PER CIRCUIT PLAN CHECK FEE San Marcos 65·626·0519
TEMP POLE 200 AMPS
OVER 200 AMPS -
TEMP OCCUPANCY (30 DAYS)
-
TOTAL ELECTRICAL I TOTAL SOLAR TOTAL FEES PAYABLE I ?-'!, Jo
I HAVE CAREFULLY EXAMINED THE COMPLETED ""APPLICATION AND PERMIT" AND DO HEREBY Expiration. Every permit issued by the Building Offlc111 under the prov1s1ons o(th1s * AN OSHA PEFWollT IS REQUIAEO FOfl EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall e•pore by lim,tallon and beeome null and vo,d If the building or work -s· 0"" DEEP ANO DEMOLITION Ofl CONSTRUCTION OF
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS authorized by such permit 1s not commenced w1thon 18:~om the date of such STRUCT\JR£S OVER 3 STOfltES IN HEIGHT
ISSUED: TO COMPLY WITH ALL CITY. COUNTY AND STATE LAWS GOVERNING BUILDING CON-~~'::~n~ 1!1 t=~v ~~~:•:ffe~~h:':~r:~!h:~:~~f~~ a n~'~,S~~~~ or .
STRUCTION. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND APo C:N,SIGNATURE 'f-t,WNE~ CONTRACTOR 0 APP_]DBY 17'q Ir'\.-KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS AND
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE -~-th -~ BY PHONE 0 ~ ~ ~ J. GRANTING OF THIS PERMIT. IT -, ' --. ~ ., --.
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.. ·-· .. -·. INSPECTION TYPE DATE INSPECTOR ---
BUILDING I
FOUNDATION ' r?. 1.~-8 7~ f!4I.
REIN~ORCED STEEL I I/
MASONRY
I
GUNITE OR GROUT
FLOOR & CEILING SUB FRAME
SHEATHING
FRAME I
EXTERIOR LATH lNSULATION
INTERIOR LATH & DRYWALL :
PLUMBING I
I --
SEWER AND BL/CO
PLUMBING UNDERGROUND I
PLUMBING TOP OUT I
TUB AND ~HOWER PAN '
GAS TEST I
ELECTRICAL ' I
TEMPORARY POWER
ELECTRIC UNDERGROUND ' '
ROUGH ELECTRIC .
'
ELECTRIC SERVICE
BONDING
G. F. I. -SMOKE DETECTOR
MECHANICAL '
DUCT & PLEM., REF. PIPING -, .. ' .
HEAT -AIR COND. -SOLAR SYSTEMS -'
VENTILATING SYSTEMS ' •· '
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
JOB SITE FINAL
PLUMBIN-G
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
CERT OF OCQ"'~NCY ISSUED I I
.. ,
'8~-~ -. I ..__ .._ ~
' ,_ f
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REQ. IF INSPECTOR'S DATE CHECKED APPROVAL
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
PILES•CAISSONS
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' INTERDEPARTMENIAL INFORMATION SHEET
BUILDING DEPARTME:.NT DlE:C E JVE D
BUILDING ADDRESS: ;2 7/7 ~ / ~., "' JJL 1 D 1982 A.P.N: ,L•L-3,U-¥3 C.T: ____________ _
* ** * ** ** * *** * *** ** * * * * * * * * * * * * *; ** * *** * * * * ** * * ** * * * ***Eirl~'i<-Oli iOAR!8BAt) *
ElfilJN I NGj)EP~RTMENT · Burlcilng Dcp.:irtment
ZONE: &-_i_ · SCHOOL FEES: SAN DIEGUITO _____ SAN MARCOS __ _
ENCINITAS ____ CARLSBAD _____ _
UNITS REQ'D: PROVIDED: tr-
% COVERAGE A-L-L0-1-VE_D_:===-=--=--=--=--=--=--=----_-_-:=__.PROVIDED: _ __,,~4 __,_.7~,__ _____ _
PARKING SPACES REQ'D: PROVIDED: ~ I
BUILDING HEIGHT REQ'D: PROVIDED: ---------
FRONT SETBACK SIDE SETBACK REAR SETBACK
ALLOWED: tJ__
PROVIDED-:~~~+o:-,_c,-_-=-_-=:._
INTRUSIONS: ------
RE-DEVELOPMENT APPROVAL REQ'D: _ __,(l},_,._ft _____ _
LANDSCAPE & IRRIGATION PLAN COMMENTS:_~fV~fl-____________ _
ENVIRONMENTAL PROTECTION REQ: t;;f.€fl'lf1 -"---'-"--'---------------
ADDITIONAL COMMENTS: ______________________ _
OK TO ISSUE: Gb OK TO FINAL: ____ DATE: ___ _
R.O.W: IMPROVEMENTS: ------------------------
PUBLIC FACILITIES FEE: SEWER CONNECTION: --------------
DRIVEWAY LOCATION(S): ___________ ~-----
GRADING PERMIT: ________________________ _
EASEMENTS: _________ DRAINAGE: _____________ _
LEGAL DESCRIPTION: ------------------------ADD 'IT ION AL COMMENTS: -----------------------
*CHECK Ir ENGI!'fEJJM IN~J~~•o. ON FINAL:
OK TO ISSUE:~ATE:_L __ ,___4'--+-1:___CJ_uw.r : ____ OK TO FINAL: ____ _
DATE: ----
Jc~*** -t; * * * *7~* * * * * * * 'k!liJ£:Js ** * * ** m1: * * * * * * * * * * * ** * * * * * u. * * * * *
* IF TIITS ITEM IS NOT CHECKED, BUTLIJJNG DEPAlffMENT W1LL MAKE
PINAL INSPECTION.